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NPI Code Detail

MEDICARE: ANAT BURDA DPT, IMT,C

MEDICARE:   ANAT  BURDA  DPT, IMT,C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2468NV

General Provider Information

NPI Number : 1215240817
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANAT BURDA DPT, IMT,C
Provider Business Mailing Address
First Line : 8876 SPANISH RIDGE AVE STE 204
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8876 SPANISH RIDGE AVE STE 204
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1502
Country : US
Telephone Number : 858-735-1416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2010
Last Update Date : 12/12/2023

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Directions to “ ANAT BURDA DPT, IMT,C” Practice Location

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